The Study On PPH And Milligan-Morgan Hemorrhoidectomy For The Therapy Of Circular Mixed Hemorrhoids

Objective:For the therapy of circular mixed hemorrhoids,the traditional methods were mainly on the operation of Milligan-Morgan which was based on the theory of varicose vein.Owing to its shortcomings of great pain,slow healing,complications,and the effects to the anal function,it became more difficult to be accepted by the patients.In 1998,according to the new theory of the formation of hemorrhoids—the theory of downward displacement of anal cushions,Italian scholar Longo invented PPH(Procedure for Prolapse and Hemorrhoids) for the treatment of circular mixed hemorrhoids and achieved good results.The main strong points were little pain,quick healing,few effects to the anal function,etc.and it had been promoted home and abroad rapidly.As PPH had developed not too long, there was not too much clinical evaluation for the therapy of circular mixed hemorrhoids.The purpose of this study was to compare the clinical efficacy of the two types of the operation methods for the treatment of circular mixed hemorrhoids,and provide scientific references for the clinicians.Methods:Random control was conducted.Sixty patients withⅢ～Ⅵperiod circular mixed hemorrhoids between 2006 August and 2007 Match from The Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College were separated into the experimental group(30 cases) and the control group(30 cases).The experimental group adopted PPH Operation,and another group used Milligan-Morgan Operation.The incision pain within 48 hours after the operation,times of taking pain medicines and the rate of postoperative complication after 30 days were analysed by x~2 test;t test were used to test the time being spending in the hospital after operation,time of healing,the changes of the maximum anal resting pressure before and after the operation.The results of test would be analyzed by SPSS 13.0.Results:Compared with the two groups,the incision pain within 48 hours after the operation had extremely remarkable differences(P＜0.01);For the average postoperative stay in hospital,the experimental group was 1.93±0.52 days,and the comparing group was 8.13±1.31days,the differences were remarkable(P＜0.05);For the average healing time after the operation,the former group was 6.97±1.33days,and the latter one is 20.23±2.47days,the differences were remarkable (P＜0.05);For the testing of the maximum anal resting pressure before the operation,the experimental group and the comparing group were 60.97±8.43 mmHg and 61.50±8.76mmHg respectively,there were no remarkable differences(P＞0.05);For the testing of the maximum anal resting pressure 30 days after the operation,the two groups were 35.87±6.04 mmHg and 44.03±7.18mmHg respectively,the differences were extremely remarkable(P＜0.01);For the rate of postoperative complication(Incision hemorrhage,edema anal margin,anal stenosis,or anal discharge or overflow) after 30 days,compared with the experimental group,the control group was lower(P＜0.01 or P＜0.05).Conclusion:For the treatment of the circular mixed hemorrhoids,PPH was more consistent with person's physiology,and it showed the significant benefits of little postoperative pain,short postoperative stay,quick rehabilitation and few postoperative complications compared with Milligan-Morgan hemorrhoidectomy.Thus,PPH was worth promoting and popularizing.